Head of PI Provider Network & Medical Operations

In The Network; Chamblee (GA); Hybride; USD 140 000 - 190 000; Plein temps

Résumé du poste

Case Portal is seeking a senior, hands-on leader to own the medical side of the business. You’ll build and grow our Georgia provider network, acting as the main contact for practice owners and administrators, and set the standard for medical documentation and compliance across the network.

You will lead a team of provider success, records, billing, and credentialing professionals, shaping contracts, credentialing, and day-to-day provider relations while partnering with product to ensure the

Qualifications

• 7+ years of experience on the medical side of personal injury.
• Hands-on knowledge of LOPs, medical liens, lien reductions, CPT/ICD-10 coding, and HCFA-1500 and UB-04 billing forms.
• Experience onboarding providers into a network, program or software platform.
• An established network of Georgia providers.
• Strong compliance judgment and a firm understanding of what is and isn’t allowed in provider relationships.

Responsabilités

• Recruit and onboard Georgia providers across orthopedics, pain management, imaging, chiropractic, neurology, surgery centers and physical therapy.
• Own provider relationships end to end: contracts, credentialing, BAAs and day-to-day issues.
• Build and lead a team of provider success reps, records and billing coordinators, and a credentialing specialist.
• Set standards for medical records, itemized bills, narratives, causation letters, and records and billing affidavits.
• Partner with our product team so the platform fits how provider offices actually work.
• Keep all provider relationships compliant with anti‑kickback and referral rules, HIPAA and Georgia lien law.

Connaissances

Medical industry experience

Leadership

Provider relations

Compliance judgment

Outils

Billing systems

Description du poste

Case Portal is seeking a senior, hands-on leader to own the medical side of the business. You’ll build and grow our Georgia provider network, acting as the main contact for practice owners and administrators, and set the standard for medical documentation and compliance across the network.

You will lead a team of provider success, records, billing, and credentialing professionals, shaping contracts, credentialing, and day-to-day provider relations while partnering with product to ensure the